Healthcare Provider Details

I. General information

NPI: 1841284114
Provider Name (Legal Business Name): BRIAN W. BALANOFF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1318 E 104TH ST
KANSAS CITY MO
64131-4504
US

IV. Provider business mailing address

14613 FARLEY ST
OVERLAND PARK KS
66221-9672
US

V. Phone/Fax

Practice location:
  • Phone: 816-256-5200
  • Fax:
Mailing address:
  • Phone: 913-907-7316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01047392
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0431503
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2023043761
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: